Whole Body Ct

Front 1

A burst fracture of the C1 ring?

Back 1

jefferson fracture

Front 2

any break in the bony ring of a vertebra that occurs on a slice that shows the __________ _______ is a spondylolysis until proved otherwise?

Back 2

basivertebral plexus

Front 3

Helps distinguish myositis ossificans from parosteal osteosarcoma?

Back 3

Parosteal sarcoma demonstrates central clumps of calcification and myositis ossificans has peripheral ossification/calcification

Front 4

Define disk bulge, sequestered or free fragment?

Back 4

Disk bulges can be diffuse, broad based, or focal but are attached to the disk. Sequestered or free fragments occur when disk material migrate from parent disk

Front 5

Distinguishing a free fragment from a Tarlov cyst or conjoined nerve root?

Back 5

A free fragment is hyperdense to thecal sac and Tarlov cyts and conjoined nerve roots are isodense to thecal sac

Front 6

Lateral disk protrusion affects what nerve root?

Back 6

A nerve rooth that has already exited the neuroforamen at a more cephalad level

Front 7

Congenital causes of spinal stenosis?

Back 7

Achondroplasia, Morquio's disease, idiopathic spinal stenosis

Front 8

Acquired spinal stenosis causes?

Back 8

Degenerative disk disease, post-traumatic stenosis, postsurgical stenosis, Paget's disease, calcification of posterior longitudinal ligament

Front 9

Anatomic classification of spinal stenosis?

Back 9

Central canal stenosis, neuroforaminal stenosis, lateral recess stenosis

Front 10

Most useful CT criteria for diagnosing central canal stenosis?

Back 10

Obliteration of epidural fat, flattening of thecal sac

Front 11

Pars interarticularis defect?

Back 11

Spondylolysis

Front 12

Anterior displacement of a cephalad vertebral body with respect to a caudad vertebral body?

Back 12

Spondylolisthesis. Grade I (<25%), II (25-50%), III (50-75%), IV (75-100%)

Front 13

Most common site for coalition?

Back 13

Calcaneonavicular joint

Front 14

Finding causing the greatest concern for metastatic bone disease or multiple myeloma involvement?

Back 14

A permeative process

Front 15

Spinal hemangioma CT features?

Back 15

vertical trabecular thickening, may contain fat, may see phleboliths

Front 16

Schmorl's node?

Back 16

Herniation of disk material through end plate of vertebral body

Front 17

Tarlov cysts?

Back 17

Nerve sheath dilatations of fluid density at CT, when large enough can cause bone erosion, particulary within the sacrum

Front 18

Paget's disease on CT?

Back 18

Purely lytic or sclerotic or mixed. Bone overgrowth, Cortical thickening, disorganized trabecular thickening, in pelvis-thickenign of iliopectineal or ilioischial lines

Front 19

Fibrous dysplasia?

Back 19

Congenital disorder of bone, fibrous tissue, chondral tissue, and even cysts within bone. Non-aggressive appearance

Front 20

Common right-sided anomalous pulmonary venous return insertions?

Back 20

SVC azygos vein, IVC, Right atrium

Front 21

Common left-sided anomalous pulmonary venous return insertions?

Back 21

Left brachiocephalic vein, persistent left SVC, Coronary sinus

Front 22

CT features that suggest lung cancer?

Back 22

Irregular or spiculated margine, Lobulated contour, Air bronchograms or cysts within nodule, Nodular cavitation, > 2 cm

Front 23

Lung hamartoma CT features?

Back 23

"Smooth, rounded, or lobulated contour. Fat 60% Fat and calcification 30% Diffuse calcification 10%--""popcorn""

Front 24

"
4 findings of rounded atelectasis?

Back 24

"1. Ipsilateral pleural thickening or effusion. 2. Contact between lung lesion and pleural surface. 3. ""comet tail"" sign. 4. Volume loss of lobe involved

Front 25

"
Air-crescent sign?

Back 25

Lung mass capped by a crescent of air. Most typical of mycetoma (fungus ball. Fungus ball (Aspergillus) forms in preexisting cyst or cavity

Front 26

Lung abscess CT features?

Back 26

Necrosis or cavitation within area of pneumonia or dense consolidation

Front 27

Satellite nodules and galaxy sign?

Back 27

Granulomatous lesions with smaller nearby nodules—satellite. In sarcoidosis, galaxy sign is a larger nodule with nearby grouped smaller nodules

Front 28

Benign pulmonary nodule calcification patterns?

Back 28

"Diffuse (granuloma), Central ""bullseye"" (histoplasmosis), Popcorn (hamartoma), Concentric ""target"" (histoplasmosis)

Front 29

"
Benign pulmonary nodule doubling times?

Back 29

< 1 month, or > 16 months

Front 30

What increase in diameter equals a doubling of volume?

Back 30

26% increase (10 mm to 12.6 mm)

Front 31

Differential, multiple large pulmonary nodules?

Back 31

Metastases Lymphoma Bronchogenic carcinoma Bacterial, fungal, and sometimes viral infections Granulomatous disease Sarcoidosis Wegener's granulomatosis Rheumatoid lung Amyloidosis Septic emboli

Front 32

Pulmonary metastasis characteristics?

Back 32

Typically round and well-defined. Cavitation and calcification can be seen

Front 33

Signet ring sign?

Back 33

Bronchiectasis. Cross section of pulmonary artery branch adjacent to dilated, ring-shaped bronchus. Bronchus diameter exceeds adjacent artery's

Front 34

Bronchiectasis patterns in cystic fibrosis and allergic bronchopulmonary aspergillosis?

Back 34

CF-bilateral, upper lobes, most severe at parahilar lungs. ABPA-central bronchiectasis

Front 35

Causes of interlobular septal thickening as predominant finding at HRCT?

Back 35

1. Lymphatic spread of carcinoma. 2. Interstitial pulmonary edema. 3. Alveolar proteinosis. 4. Sarcoidosis

Front 36

Common causes of fibrosis and honeycombing as predominant HRCT findings?

Back 36

IPF 65%, Collage vascular diseases (RA, scleroderma), Drug-related fibrosis, Asbestosis, End-stage hypersensitivity pneumonitis, End-stage sarcoidosis

Front 37

3 distributions of pulmonary nodules at HRCT?

Back 37

Perilymphatic nodules (pleural surface, large vessels and bronchi, interlobular septa, centrilobular regions), Random nodules (miliary TB, hematogenous metastases), Centrilobular nodules (tree-in-bud--endobronchial TB, MAC/MAI, CF, bronchiectasis, bronchopneumonia)

Front 38

CT features of pulmonary lymphangitic spread of carcinoma?

Back 38

Interlobular septal thickening, Peribronchial interstitial thickening, Thickening of fissures, Lymph node enlargement, Patchy distribution

Front 39

CT features of pulmonary hematogenous spread of tumor?

Back 39

Random distribution, Fissures and pleural surface involvement, Bilateral, Large nodules

Front 40

CT features of IPF (idiopathic pulmonary fibrosis--UIP is histology pattern)?

Back 40

Intralobular interstitial thickening, Honeycombing, Traction bronchiectasis and bronchiolectasis, Subpleural, posterior, and basal lungs, Ground-glass opacity

Front 41

Nonspecific interstitial pneumonia (NIP, collagen vascular disease) CT features?

Back 41

Ground-glass opacity, Posterior basal lungs-sparing immediate subpleural lung, Reticulation, traction bronchiectasis and bronchiolectasis, Honeycombing-rare

Front 42

Active sarcoidosis CT features?

Back 42

Perilymphatic nodules, Patchy, upper lobe predominance, Hilar, mediastinal node enlargement, Ground-glass opacity (small granulomas)

Front 43

HRCT findings in end-stage sarcoidosis?

Back 43

Irregular septal thickening, Architectural distortion, Parahilar conglomerate masses, Honeycombing, Hilar and mediastinal node enlargement

Front 44

Pulmonary lymphangitic spread of carcinoma?

Back 44

Interlobular septal thickening, Peribronchial interstitial thickening Patchy or unilteral distribution Lymph node enlargement

Front 45

Pulmonary hematogenous spread of tumor?

Back 45

Random distribution, Involvement of fissures and pleural surfaces, Bilateral distribution, Large nodules

Front 46

Idiopathic pulmonary fibrosis CT features?

Back 46

Intralobular thickening, Honeycombing, Traction bronchiectasis and bronchiolectasis, Predominant subpleural, posterior, basal lung regions, Ground-glass opacity

Front 47

Nonspecific interstitial pneumonia CT features?

Back 47

Ground-glass opacity, Predominant posterior and basal lung, sparing the immediate subpleural lung, Reticulation, traction bronchiectasis and bonchiolectasis, Honeycombing

Front 48

Collagen vascular disease as lung disease?

Back 48

Rheumatoid lung, scleroderma, and other collagen disease (UIP, NSIP, BOOP)

Front 49

Active pulmonary sarcoidosis CT features?

Back 49

Perilymphatic nodules, Patchy, Upperlobe predominance, Hilar, mediastinal nodes, Ground-glass opacity, small granulomas

Front 50

End-stage sarcoidosis?

Back 50

Irregular septal thickening, Architetural distortion, Parahilar conglomerate, honeycombing, Hilar, mediastinal nodes

Front 51

Silicosis and Coal Worker's pneumoconiosis?

Back 51

Perilymphatic nodules, Symmetric distribution, Posterior lung predominance, Upper lobe predominance, Conglomerate masses, Hilar, mediastinal nodes (egg-shell calcification)

Front 52

Pulmonary Tuberculosis CT features?

Back 52

Endobronchial spread (centrilobular nodules, tree-in-bud, focal areas of consolidation, bronchial wall thickening or bronchiectasis, pathcy or focal), Miliary spread (random nodules, 1-5 mm, Usually diffuse)

Front 53

Pulmonary alveolar proteinosis?

Back 53

"Filling of alveolar spaces with lipid-rich proteinaceous material, Patchy or geographic ground-glass opacity, smooth, interlobular septal thickening in ground-glass--""crazy paving""""

Front 54

"
Hypersensitivity pneumonitis, subacute stage CT features?

Back 54

Patchy or geographic ground-glass opacity, Poorly defined centrilobular nodules or ground-glass opacity, Mosaic perfusion, Air trapping

Front 55

Bronchiolitis obliterans organizing pneumonia, causes?

Back 55

Idiopathic, infections, toxic exposures, drug reactions, autoimmune disease

Front 56

HRCT features of bronchiolitis obliterans organizing pneumonia?

Back 56

Patchy or nodular consolidation, Patchy or nodular ground-glass opacity, Peripheral and peribronchial distribution

Front 57

Chronic eosinophilic pneumonia?

Back 57

Filling of alveoli by mixed inflammatory infiltrate (eosinophils), similar to BOOP--patchy consolidation or ground-glass, peripheral distribution

Front 58

Histiocytosis (aka Langerhans histiocytosis or eosinophilic granuloma)?

Back 58

Centrilobular nodules (may cavitate), Thin-walled, irregular lung cysts, Normal appearing intervening lung, Upper lobe predominance, Spares costophrenic angles

Front 59

Lymphangiomyomatosis?

Back 59

Women of child bearing age, can occur in Tuberous sclerosis, too, Thin-walled, round lung cysts, Normal-appearing intervening lung, Lymph node enlargement, Diffuse distribution without sparing lung bases

Front 60

List 4 types of emphysema?

Back 60

Centrilobular (upper lobes, smokers, most common form), Panlobular (less common, alpha1-antitrypsin, most severe at lung bases), Paraseptal (subpleural lung, adjacent to chest wall and mediastinum), Bullous (Large bullae, young men)

Front 61

Split pleura sign?

Back 61

Thickened visceral and parietal pleural layers are split apart and surround an empyema

Front 62

Extension of an empyema to involve the chest wall is termed?

Back 62

empyema necessitatis

Front 63

Lung abscess versus empyema CT characteristics?

Back 63

Abscess (poorly defined, irregular wall, spherical, multiple cavities, acute angles, vessels not displaced), Empyema (well defined, smooth, uniform wall, elliptical, split pleura, acute or obtus angles, vessels displaced)

Front 64

CT features of a malignant effusion?

Back 64

Nodular pleural thickening, pleural thickness > 1 cm, concentrically involves the pleura, encasing the lung, thickening of mediastinal pleura

Front 65

CT findings for chest wall invasion?

Back 65

Extensive contact between tumor and chest wall (> 3cm or ratio > 0.7), Obtuse angles, Chest wall mass, Bone destruction

Front 66

What passes through the aortic hiatus?

Back 66

Aorta, azygos, hemiazygos, thoracic duct, intercostal arteries, splanchnic nerves

Front 67

What passes through the esophageal hiatus?

Back 67

Esophagus, vagus nerve, small blood vessels

Front 68

Anterior mediastinal node groups?

Back 68

Internal mammary nodes, Paracardiac nodes, Prevascular nodes

Front 69

Middle mediastinal node groups?

Back 69

Pretracheal or paratracheal nodes, Aortopulmonary nodes, Subcarinal noes, Peribronchial nodes

Front 70

Posterior mediastinal node groups?

Back 70

Paraesophageal nodes, Inferior pulmonary ligament nodes, Paravertebral nodes

Front 71

Upper limits of normal for subcarinal lymph node diameter?

Back 71

1.5 cm

Front 72

Egg-shell calcified mediastinal lymph node, differential?

Back 72

Silicosis, Coal worker's pneumoconiosis, Sarcoidosis, Tuberculosis

Front 73

Calcified mediastinal lymph node, differential?

Back 73

Prior granulomatous disease (TB, histo, fungal, sarcoidosis), Silicosis, Coal worker's pneumoconiosis, treated Hodgkin's disease, Metastasis

Front 74

Mediastinal lymph node enhancement?

Back 74

Castleman's disease, Angioimmunoblastic lymphadenopathy, Vascular metastases, TB, Sometimes sarcoidosis

Front 75

Left upper lobe cancers involve what mediastinal lymph node group?

Back 75

Aortopulmonary window nodes

Front 76

Lower lobe lung cancers involve what mediastinal lymph node group?

Back 76

Subcarinal nodes

Front 77

Resectability non-small cell lung cancer stages?

Back 77

Stage IIIb-IV, contralateral lymph nodes are N3, unresectable

Front 78

Sarcoidosis thoracic adenopathy features?

Back 78

Symmetric hilar adenopathy, Lymphoma is typically asymmetrical

Front 79

Prevascular space tumors?

Back 79

4Ts: thymoma, teratoma, thyroid tumor, terrible lymphoma. Other germ-cell tumors, parathyroid masses, lymphangioma

Front 80

Castleman's disease

Back 80

aka angiofollicular lymph node hyperplasia Focal form (Enhancing hilar or mediastinal lymph nodes) Diffuse form (Enhancing mediastinal, hilar, axillary, abdominal, and inguinal node)

Front 81

CT features of thymoma?

Back 81

Prevascular or paracardiac location, Typically unilateral, Calcification or cystic degeneration can be present

Front 82

Thymic masses?

Back 82

Thymoma, thymic carcinoma, thymic carcinoid tumor, thymolipoma, thymic cyst thymic hyperplasia and rebound (after cessation of chemotherapy)

Front 83

Three main categories of germ-cell tumors?

Back 83

1. Teratoma and dermoid cyst, 2. Seminoma (radiosensitive), 3. Non-seminomatous germ-cell tumors (poor prognosis: choriocarcinoma, endodermal sinus tumor, mixed tumors)

Front 84

Teratoma versus dermoid cyst?

Back 84

Teratoma contains ecto-, meso-, and endodermal origins (can be cystic, contain fat, have fat-fluid level, or calcify. Can be mature or immature (malignant. Dermoid cyst primarily from epidermal tissue

Front 85

Lymphangioma types?

Back 85

Simple--small, thin-walled with connective tissue. Cavernous--dilated lymphatic channels. Cystic--hygromas, single or multiple cystic masses filled with serous or milky fluid

Front 86

Saber-sheath trachea features?

Back 86

Narrowed lateral dimension of intrathoracic trachea. COPD, repeated trauma from coughing

Front 87

Concentric tracheal narrowing causes?

Back 87

Intubation, Polychondritis, Wegener's granulomatosis, Amyloidosis, Tracheobronchopathia osteochondroplastica

Front 88

Bronchogenic and esophageal duplication cyst features?

Back 88

Anomalous budding of foregut. Most commonly within subcarinal space. Esophageal duplication cyst indistinguishable from bronchogenic, except they always contact the esophagus

Front 89

Paravertebral neurogenic tumor divisions?

Back 89

1. Peripheral nerve or nerve sheath (neurofibroma, neurilemmoma--young adults. 2. Sympathetic ganglia (ganglioneuroma, neuroblastoma—children. 3. Paraganglionic cells (pheochromocytoma, chemodectoma)

Front 90

Most common cause of posterior mediastinal mass in patients with neurofibromatosis?

Back 90

Meningocele

Front 91

Granulomatous mediastinitis causes?

Back 91

Histoplasmosis, TB, Sarcoidosis, Chronic mediastinal lymph node enlargement with fibrosis. Calcification of lymph nodes common

Front 92

Sclerosing mediastinitis versus granulomatous mediastinitis

Back 92

Similar but no calcification with sclerosing mediastinitis

Front 93

Pericardial cyst features?

Back 93

60% anterior right cardiophrenic angle, 30% left cardiophrenic angle, 10% occur higher in mediastinum

Front 94

Morgagni hernia features?

Back 94

Anteromedial diphragmatic foramen of Morgagni. Cardiophrenic angle mass, 90% occur on right. Usually contains liver or omentum

Front 95

Right upper lung lobe segments?

Back 95

Apical Posterior Anterior

Front 96

Left upper lung lobe segments?

Back 96

Apicoposterior Anterior Superior lingula Inferior lingula

Front 97

Right middle lung lobe segments?

Back 97

Medial Lateral

Front 98

Right lower lung lobe segments?

Back 98

Superior Anterior Medial Lateral Posterior

Front 99

Left lower lung lobe segemnts

Back 99

Superior Anteromedial Lateral Posterior

Front 100

Egg-shell calcification of thoracic lymph nodes?

Back 100

Silicosis, Sarcoidosis, TB

Front 101

Pulmonary agenesis versus pulmonary aplasia?

Back 101

Aplasia has rudimentary bronchus

Front 102

Pulmonary arteriovenous fistula features?

Back 102

Single dilated vascular sac or tangle of dilatated tortuous vessels. Mostly subpleural, Rapid enhancement and rapid washout

Front 103

Pulmonary sequestration features?

Back 103

Cystic or solid, Majority left posteromedial lung. All have anomalous systemic arterial supply

Front 104

Intralobar sequestration versus Extralobar sequestration?

Back 104

Intralobar: diagnosed in adults, recurrent or chronic infection, region of hyperlucent lung, cystic or multicystic structure with air-fluid levels, consolidated or collapsed lung. Extralobar: diagnosed in infants or children, almost always solid mass that rarely contains air. Venous drainage usually via systemic veins

Front 105

Hypogenic lung sydrome (scimitar)?

Back 105

almost always on right side, hypoplasia of lung, hypoplasia of ipsilateral pulmonary artery, Anomalous pulmonary venous return (scimitar vein) to vena cava or right atrium. Anomalous systemic arterial supply to portion of hypoplastic lung

Front 106

Extraperitoneal space communicates with?

Back 106

Retroperitoneal space, retropubic space of Retzius continuous with posterior pararenal space and extraperitoneal fat of abdominal wall

Front 107

Perineum

Back 107

Lies below pelvic diaphragm, includes ischiorectal fossa

Front 108

Normal fertile ovary dimensions?

Back 108

2 x 3 x 4 cm

Front 109

Bladder carcinoma CT features?

Back 109

Focal thickening of bladder wall, Weakly enhancing mural nodule, Calcifications 5%, Perivesical fat spread, Pelvic lymph nodes > 10 mm

Front 110

Uterine leiomyoma CT features?

Back 110

40% of women > 30 yo, homogeneous, heterogeneous masses, hypodense,isodense, or hyperdense, dystrophic, mottled calcifications, cystic degeneration

Front 111

Carcinoma of cervic features?

Back 111

SCC 85%, ADCA 15%, hypo or isodense to normal cervix, Pelvic fluid collections, Direct extension (thick irregular tissue strands), Enlarged lymph nodes > 10 mm

Front 112

Endometrial malignancy features?

Back 112

hypodense mass within endometrial cavity, surgical staging method of choice, Enlarged pelvic lymph nodes > 1 cm

Front 113

Ovarian cancer features?

Back 113

cystic 66%, bilater 25%, Nonfunctional 85%, Cystic with thick, irregular walls and internal septations. Peritoneal implants, Ascites, Omental cake (irregular, thick greater omentum), follow gonadal lymphatics

Front 114

Normal ovarian follicle size?

Back 114

<3 cm

Front 115

Functional ovarian cyst features?

Back 115

Benign follicular or corpus luteum cysts, well-defined, thin walled, < 3 cm

Front 116

PID CT features?

Back 116

Thickening of fallopian tubes (early), Enlargement and abnormal enhancement of ovaries, Dilated fallopian tubes filled with high-density fluid (advanced-pyosalpinx), Complex adnexal fluid collections (abscess)

Front 117

Adnexal torsion, CT features?

Back 117

Most cases involve mass (benign cystic teratoma, hydrosalpinx, functional cyst), Thickening fallopian tube wall, ascites, deviation of uterus to affected side

Front 118

Testicular cancer lymph node involvement?

Back 118

Gonadal lymphatics (testicular veins and renal hilar nodes), external iliac chains to para-aortic nodes. Inguinal nodes involved only when scotrum invaded

Front 119

Aberrant right subclavian artery?

Back 119

Left arch, last branch (diverticulum of Kommerell), courses behind esophagus

Front 120

Two types of right aortic arch?

Back 120

Right arch with aberrant left subclavian, Mirror image right arch (almost always associated with congenital heart disease)

Front 121

Double aortic arch?

Back 121

Vascular ring with dysphagia, no innominate artery (subclavians and carotids come off separately)

Front 122

Ascending aortic aneurysm causes?

Back 122

atherosclerosis, Marfan's syndrome, cystic medial necrossi, syphilis, aortic valvular disease

Front 123

3 common locations for aortic trauma?

Back 123

Aortic root level of ligamentum arteriosum diaphragm and aortic hiatus

Front 124

Stanford aortic dissection types?

Back 124

Type A--involves ascending aorta (treated surgically: possibility of retrograde dissection and rupture within pericardium or occlusion of coronary or carotid arteries), Type B--Do not involve arch, arise distal to left subclavian artery (treated medically)

Front 125

DeBakey's aortic dissection types?

Back 125

Type I--entire aorta, Type II--ascending aorta only, Type III--descending aorta only

Front 126

Three mediastinum compartments?

Back 126

supra-aortic mediastinum, subaortic mediastinum, paracardiac mediastinum

Front 127

Mediastinal spaces and recesses?

Back 127

Pretracheal space, Prevascular space, Superior pericardial recess, Azygoesophageal recess, Subcarinal space

Front 128

Persistent left superior vena cava features?

Back 128

Failure of cardinal vein to regress, Lateral to left common carotid artery, enters coronary sinus posterior to left atrium

Front 129

Azygos or hemiazygos continuation of IVC?

Back 129

Hemiazygos (polysplenia), Azygos (asplenia), dilated azygos, hemiazygos systems, Diaphragmatic IVC drains hepatic veins only

Front 130

Causes of SVC syndrome?

Back 130

Most commonly bronchogenic carcinoma, sarcoidosis, fibrosing mediastinitis, tuberculosis, mediastinal radiation

Front 131

Pulmonary artery diameter in pulmonary hypertension?

Back 131

>3 cm, or > ascending aorta

Front 132

Difference in pulmonary dilatation in pulmonary hypertension and pulmonic stenosis?

Back 132

Pulmonic stenosis--main and left pulmonary arteries dilated. Pulmonary hypertension--mian, left, and right pulmonary arteries dilated

Front 133

Acute PE versus chronic PE at CT?

Back 133

acute PE--clot centered in lumen, outlined by contrast [doughnut sign (cross section) and railroad track sign (same plane)], Chronic PE--clot adherent to wall, located peripherally

Front 134

Acute pancreatitis CT findings?

Back 134

Enlargement decrease in density blurring of margins peripancreatic stranding blurring of fat planes thickening of retroperitoneal fascia

Front 135

Complications of acute pancreatitis?

Back 135

Fluid collections Pseudocysts Necrosis (lack of enhancement) Phlegmon (mass of edema and inflammation) Abscess Hemorrhage Pseudoaneurysms Thrombosis (splenic vein) ascites

Front 136

Chronic pancreatitis features?

Back 136

"Causes (alcohol, autoimmune, tropical pancreatitis) Calcifications 50% Atrophic Duct strictured and dilated segments, ""beaded"" Pseudocysts"

Front 137

CT features of pancreatic adenocarcinoma?

Back 137

hypodense mass 96% head > body > tail

Front 138

Signs of pancreatic adenocarcinoma resectability?

Back 138

Isolated pancreatic mass Double duct sign without mass

Front 139

Signs of pancreatic adenocarcinoma unresectability?

Back 139

Involvement of major arteries or veins. Extension of tumor beyond margins of pancreas, invasion of adjacent organs, Ascites (presumtive peritoneal carcinomatosis)

Front 140

Appendicitis CT features?

Back 140

Distended appendix >6 mm, enhancing thickened walls, appendicolith within phlegmon or abscess

Front 141

Differential of RLQ pain without abnormal appendix or appendicolith?

Back 141

Crohn's disease, cecal diverticulitis, perforated cecal carcinoma, mesenteric adenitis, PID

Front 142

Complications associated with perforated appendicitis?

Back 142

Phlegmon (periappendiceal soft-tissue mass), abscess (> 3cm surgical or catheter drainage)

Front 143

Mucocele of appendix?

Back 143

Distended, mucus-filled appendix without inflammation. >2 cm, usually caused by mucinous neoplasm

Front 144

Diverticulitis CT features?

Back 144

Small, round collections of air, feces, or contrast, wall thickening, hyperemic enhancement, sinus tract or fistual formation, Abscess formation

Front 145

Colitides?

Back 145

Ulcerative colitis, Crohn's colitis, Pseudomembranous colitis, Typhlitis, Ischemic colitis (splenic flexure, rectosigmoid) Radiation colitis, Infectious colitis, Toxic megacolon

Front 146

CT features of islet cell tumors?

Back 146

Small tumors (<4 cm) enhance. Large tumors heterogeneous with calcification, cysts, necrosis, vascular invasion, tumor extension (generally nonfunctioning)

Front 147

Functioning islet cell tumors' malignant potential?

Back 147

80% glucagonoma 60% gastrinoma 10% insulinoma

Front 148

CT features of pancreatic lymphoma?

Back 148

Focal tumor, homogeneous and weakly enhancing. Diffuse infiltrative tumor resembles pancreatitis. Peripancreatic lymphadenopathy. No or minimal dilatation of pancreatic duct. Lymphadenopathy below renal veins in lymphoma but not in pancreatic adenocarcinoma?

Front 149

Metastases to pancreas CT features?

Back 149

Round or ovoid Most heterogeneous, can be diffuse, solitary, or multiple nodules

Front 150

Intraductal papillary mucinous neoplasm CT features?

Back 150

"Diffuse or segmental dilation of pancreatic duct, atrophy of pancreas, cystic ectasia of branch ducts ""bunch of grapes"", intraductal papillary solid mass, multicystic mass

Front 151

Pseudocyst CT features?

Back 151

Most common cystic lesion in and around pancreas, low-density collections of fluid, debris, or blood, Distinct walls with occasional calcifications, Generally unilocular, Signs of pancreatitis usually present

Front 152

Pancreatic mucinous cystic neoplasm CT features?

Back 152

Middle-aged women, Multiloculated cysts, 6 or less cysts > 2 cm are typical, May have calcifications, Most common in tail, Do not communicate with pancreatic duct

Front 153

Pancreatic serous cystadenoma CT features?

Back 153

Benign, well-circumscribed mass of innumerable small cysts. May have central stellate scar with central calcification. With larger cysts may have honeycomb appearance, Unilocular form indistinguishable from mucinous cystic neoplasms

Front 154

Splenic cysts?

Back 154

Posttraumatic cyst (most common), Congenital epidermoid cyst, Echinococcal cysts, Pancreatic pseudocyst

Front 155

Splenic microabscesses CT features?

Back 155

Multiple low-density lesions, differential: lymphoma, kaposi's sarcoma, sarcoidosis, metastases

Front 156

Most common neoplasm of spleen?

Back 156

Hemangioma

Front 157

Rare primary malignancy of spleen?

Back 157

Angiosarcoma

Front 158

Multiple small focal splenic calcifications?

Back 158

Histoplasmosis or TB

Front 159

Features of esophageal carcinoma?

Back 159

Lack of serosa, early spread, poor prognosis. 90% SCC 10% ADCA (Barrett's) Irregular wall thickening >3 mm Intraluminal polypoid mass Eccentric narrowing of lumen Proximal dilatation Metastases to lymph nodes and liver

Front 160

Esophageal leiomyoma features?

Back 160

Smooth, well-defined mass. Eccentric wall thickening, Leiomyosarcoma (heterogeneous, ulcerate)

Front 161

Esophageal varices, CT features?

Back 161

Well-defined, enhancing nodular and tubular densities adjacent to esophagus

Front 162

Esophagitis causes?

Back 162

Candida, herpes simplex, cytomegalovirus, TB

Front 163

Paraesophageal hernia?

Back 163

Gastric cardia and gastroesophageal junction below esophageal hiatus, Fundus of stomach above hiatus, adjacent to distal esophagus

Front 164

Gastric hernia rotations?

Back 164

Organoaxial (long axis rotation. Mesenteroaxial (upside down stomach)

Front 165

Gastric varcies without esophageal varices?

Back 165

hallmark findikng of splenic vein thrombosis

Front 166

Small bowel malignant tumors?

Back 166

Lymphoma (masses, nodular wall thickening), Hematogenous metastases (melanoma, breast lung, RCC), Carcinoid (appendix, mesenteric small bowel, fibrosing reaction) Adenocarcinoma (duodenum) Leiomyosarcoma (large, exophytic, necrosis)

Front 167

Crohn's disease CT features?

Back 167

"Terminal ileum 80%, Circumferential thickening (target and double halo), Marked wall enhancement, ""comb sign"" hyperemic vasa recta, Segmental strictures, Skip areas, Fistulas and sinus tracts, abscesses

Front 168

Complete mechanical SBO?

Back 168

Dilatation of SB > 2,5 cm, distinct transition zone

Front 169

Paralytic ileus?

Back 169

Dilatation of distal and proximal SB without transition zone

Front 170

Partial mechanical SBO?

Back 170

Transition zone less distinct, small bowel feces

Front 171

Sclerosing mesenteritis features?

Back 171

Inflammatory disorder of unknown cause, chronic inflammation, fat necrosis, fibrosis, misty mesentery

Front 172

Cystic mesenteric masses?

Back 172

Cystic lymphangiomas, Cystic mesothelioma (rare, benign tumor) cystic teratomas (fat, calcification)

Front 173

Mesenteric neoplasms?

Back 173

Lymphoma (most common), Metastases (more common than primary tumors), Mesenteric fibromatosis (desmoid tumor), GISTs (large, hemorrhage, necrosis) Sarcomas (leiomyosarcoma, fibrosarcoma, malignant fibrous histiocytoma,liposarcoma)

Front 174

Colon volvulus types?

Back 174

Sigmoid volvulus (most common, mesenteric whirl), Cecal volvulus, Cecal bascule (folding rather than twisting of cecum)

Front 175

Fibrolammelar Carcinoma CT features?

Back 175

Large mass in healthy liver Enhances prominently and heterogeneously Central scar Difficult to distinguish from FNH

Front 176

Liver lymphoma CT features?

Back 176

Diffuse infiltration, Well-defined, homogeneous low-density nodules, Numerous small nodules resembling microabscesses

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Hepatic adenoma CT features?

Back 177

Young women on oral contraceptives. Men on anabolic steroids. Glycogen storage disease (multiple. Surgical removal for fear of rupture or malignant transformation. Unenhanced, isodense to liver. Arterial phase, early homogeneous enhancement. Few Kupffer cells, no sulfur colloid uptake

Front 178

FNH CT features?

Back 178

Mini liver central stellate scar and fibrous bands. Unenhanced, isodense to liver. Arterial phase, immediate intense homogeneous enhancement. May have delayed enhancement of scar. Positive sulfur colloid uptake

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Cavernous Hemangioma CT features?

Back 179

Unenhanced, hypodense mass. Arterial phase, peripheral nodules of contrast. Venous phase, progressive filling-in from periphery. Delayed, prolonged enhancement. Small hemangiomas, immediate homogeneous enhancement

Front 180

Cystic liver masses?

Back 180

Hepatic cysts Pyogenic abscess Amebic abscess Hydatid cyst

Front 181

Normal bile duct measurements?

Back 181

Intrahepatic ducts 2 mm in central liver. Common duct < 6 mm. Give 1 mm per decade in elderly

Front 182

CT findings of biliary obstruction?

Back 182

Dilated intrahepatic biliary ducts, Dilatation of common duct > 7 mm, Gallbladder diameter > 5 cm

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Precursors of choriocarcinoma?

Back 183

Choledochal cyst Primary sclerosing cholangitis Caroli's disease intrahepatic stone disease Clonorchiasis

Front 184

cholangiocarcinoma CT features?

Back 184

Intrahepatic mass-forming, homogeneous tumor with irregular borders. Periductal infiltrating lesions grow along bile ducts. Intraductal tumors, polypoid or sessile. Extrahepatic cholangiocarcinoma, duct obstructing tumor

Front 185

CT features of primary sclerosing cholangitis?

Back 185

Multiple segmental strictures (beaded appearance) with thickening of bile duct. Complications: obstruction, cholestasis, biliary cirrhosis, cholangiocarcinoma

Front 186

Choledochal cyst types?

Back 186

Type I, cystic dilation of CBD. Type II, CBD diverticulum. Type III, choledochocele, protrudes into duodenal lumen. Type IVa, intrahepatic saccular dilatations. IVb, extrahepatic multiple cystic dilatations. Type V, Caroli's disease

Front 187

CT findings of acute cholecystitis?

Back 187

Gallstones in gallbladder 75%, GB distension > 5 cm, GB wall thickening > 3 mm, Early-phase enhanced GB fossa, Pericholecystic stranding, Air in GB wall (emphysematous)

Front 188

Gallbladder carcinoma CT features?

Back 188

Polypoid soft-tissue mass, Focal or diffuse wall thickening, Mass containing stones replaces GB and invades liver

Front 189

CT features of lymphoma in abdomen

Back 189

Multiple enlarged nodes, Coalescence of enlarged nodes to form multinodular masses which may encase vessels, Conglomerate nodal masses

Front 190

CT features of AIDS in abdomen?

Back 190

Lymphadenopathy (MAI, lymphoma, Kaposi's), Focal, small low-density liver lesions (TB, Histo, lymphoma, Kaposi) Focal, small low density spleen lesions (MAI,Cocci, candida, PCP, lymphoma) Splenic or LN calcifications (PCP) Nephromegaly with striated nephrogram (HIV nephropathy) Kaposi's sarcoma (adenopathy, hepatosplenomegaly) AIDS-related lymphoma (any solid mass)

Front 191

Surgical indications for splenic trauma?

Back 191

Active bleeding, Large nonperfused portions Pseudoaneurysm formation

Front 192

Cortical rim sign?

Back 192

Delayed finding. Faint enhancement of kidney periphery in renal infarction. Renal capsule supplied by separate arteries

Front 193

Complications of pancreatic trauma?

Back 193

Pseudocyst formation hemorrhagic pancreatitis Abscess Fistula

Front 194

Shock bowel?

Back 194

Severe hypotension and hypoperfusion of bowel. Diffuse dilation of small bowel with wall thickening and increased wall enhancement

Front 195

Extraperitoneal bladder rupture?

Back 195

Contrast leakage into retropubic space, along abdominal wall, scrotum, thigh, and retroperitoneum

Front 196

Intraperitoneal bladder rupture?

Back 196

Contrast in paracolic gutters and surrounding bowel

Front 197

Which adrenal gland more susceptible to traumatic injury?

Back 197

Right adrenal gland. compression of gland between liver and spine

Front 198

Liver segment I?

Back 198

Caudate lobe, Ligamentum venosum and IVC separate it from liver

Front 199

Liver segments II and III?

Back 199

Lateral division of left lobe. II-superior. III-inferior

Front 200

Liver segments IV?

Back 200

Medial division of left lobe. IVa-superior. IVb-inferior

Front 201

Liver segments V and VIII?

Back 201

Anterior segments of right lobe. VIII-superior. V-inferior

Front 202

Liver segments VI and VIII?

Back 202

Posterior segments of right lobe. VII-superior. VI-inferior

Front 203

Third inflow?

Back 203

Areas of liver supplied by aberrant systemic veins. Porta hepatis, adjacent to gallbladder, adjacent to fissure of ligamentum teres

Front 204

Increased liver attenuation?

Back 204

Amiodarone Hemochromatosis (secondary form-hemosiderosis, blood transfusions)

Front 205

Liver nodules in cirrhosis?

Back 205

Regenerative nodules Dysplastic nodules Small HCC nodules Metastatic disease Hemangiomas

Front 206

CT features of portal hypertension?

Back 206

Portosystemic collateral vessels Enlarged portal vein, > 13 mm. Splenomegaly Ascites

Front 207

CT features of Budd-Chiari syndrome?

Back 207

Enlarged caudate lobe. Central liver enhances early and peripheral liver enhances late

Front 208

Clinically significant liver lesions?

Back 208

Metastases Hepatoma Hepatic adenoma

Front 209

Metastases to liver features on CT?

Back 209

Most common liver malignancy. Most commonly from colon. Target appearance. Hypervascular (carcinoid, choriocarcinoma, pheochromocytoma, RCC, thyroid cancer. Some cystic/nectrotic, calcification

Front 210

HCC CT features?

Back 210

50% solitary tumor 30% infiltrative 20% multinodular Small tumors, < 3cm bright homogeneous enhancement Necrosis and calcification common Invasion of hepatic and portal veins

Front 211

How much must a renal mass enhance in Hounsfield units before it is considered enhanced?

Back 211

10 - 15 H

Front 212

Metastatic lymph node size in RCC?

Back 212

> 2 cm nearly alwasy metastatic 1 - 2 cm indeterminate

Front 213

Most common sites for RCC metastases?

Back 213

lungs mediastinum bone liver contralateral kidney adrenal gland brain

Front 214

Bosniak cystic renal mass categories?

Back 214

Category I Benign simple cyst Category 2 Benign Complicated Category 3 Indeterminate cystic lesions Category 4 Malignant cystic tumors (enhancing soft tissue)

Front 215

VHL and TS CNS involvement differences?

Back 215

VHL--cerebellar, spinal cord, and retinal hemangioblastomas. TS--retinal and cerebral hamartomas

Front 216

Emphysematous pyelonephritis versus emphysematous pyelitis?

Back 216

Emphysematous pyelonephritis: diabetes, urinary obstruction, gas in renal parynchema, nephrectomy. Emphysematous pyelitis: gas in pelvis and calyces (trauma, iatragenic, infection), not a surgical urgency

Front 217

Renal stone not seen at CT?

Back 217

Crystallin stones related to indinavir (protease inhbitor HIV Rx)

Front 218

What size renal stones can pass on their own?

Back 218

< 4 mm nearly always pass. > 8 mm rarely pass

Front 219

Tissue rim sign?

Back 219

Halo of soft tissue that surrounds ureter stone

Front 220

Absence of white pyramids?

Back 220

Subtle sign of urinary obstruction on affected side

Front 221

Phlebolith distinguishers?

Back 221

tail sign (vein), central lucency, round

Front 222

Adrenocortical carcinoma features?

Back 222

large > 5 cm Necrosis and calcification Delayed contrast washout

Front 223

Adrenal calcification causes?

Back 223

Children (neuroblastoma, gnaglioneuroma) Adult (adrenal carcinoma, pheochromocytoma, glanglioneuroma, metastases) Wolman's disease (autosomal recessive, enlarged calcified adrenal glands, hepatosplenomegaly)

Front 224

In adrenal hyperplasia, adrenal limb thickness exceeds?

Back 224

10 mm

Front 225

Organ of Zuckerkandl?

Back 225

Common location for extra-adrenal pheochromoctyoma. Near origin of IMA

Front 226

Common metastases to adrenal glands?

Back 226

Lung Breast Melanoma

Front 227

Lipid-rich adrenal adenoma Hounsfield units?

Back 227

< 10 H

Front 228

Lipid-poor adrenal adenoma features?

Back 228

Non-contrast H > 10 Enhancement washout > 50% 15 minute post-contrast H < 35

Front 229

Serous ascites attenuation value in H?

Back 229

-10 to +15

Front 230

Hemoperitoneum attenuation value in H?

Back 230

>35, averaging 45 H

Front 231

With absence of intrahepatic segment of IVC, how does lower body venous blood reach the heart?

Back 231

Drainage to SVC via azygos system?

Front 232

Aneurysmal diameters of abdominal aorta and iliac arteries?

Back 232

AAA > 3 cm Iliac aneurysm > 1

Front 233

5 cm
Hyperattenuating crescent sign?

Back 233

Crescent area of high attenuation (dissecting contrast) within wall or intraluminal thrombus of AAA, impending rupture

Front 234

Beak sign in distinguishing true lumen from false lumen in aortic dissection?

Back 234

Intimal flap and false lumen wall create an acute angle: beak sign

Front 235

Dilatation of vein at site of DVT means acute or chronic?

Back 235

Acute

Front 236

Abdominal and retrocrural lymph node pathologic size cutoff?

Back 236

Abdominal LN > 10 mm. Retrocrural LN > 6 mm